Autonomic cardiovascular control recovery in quadriplegics after handcycle training

• Published in: Journal of Physical Therapy Science Vol. 28; no. 7; pp. 2063 - 2068
• Main Authors: Elizângela Márcia de Carvalho Abreu, Borges, Ana Carolina Lacerda, Alderico Rodrigues de Paula Júnior, Alves, Rani de Souza, Lima, Fernanda Pupio Silva, Lima, Mário Oliveira
• Format: Journal Article
• Language: English
• Published: Japan The Society of Physical Therapy Science 01.01.2016
• Subjects: Exercise training response; Heart rate variability; Original; Spinal cord injury; Exercise training response; Spinal cord injury; Heart rate variability
• ISSN: 0915-5287; 2187-5626
• DOI: 10.1589/jpts.28.2063

[Purpose] The aim of this study was to investigate the cardiovascular autonomic acute response,during recovery after handcycle training, in quadriplegics with spinal cord injury (SCI).[Subjects and Methods] Seven quadriplegics (SCIG −level C6–C7, male, age 28.00 ±6.97 years) and eight healthy subjects (CG −male, age 25.00 ± 7.38 years) were studied.Their heart rate variability (HRV) was assessed before and after one handcycle training.[Results] After the training, the SCIG showed significantly reduced: intervals between Rwaves of the electrocardiogram (RR), standard deviation of the NN intervals (SDNN), squareroot of the mean squares differences of sucessive NN intervals (rMSSD), low frequencypower (LF), high frequency power (HF), and Poincaré plot (standard deviation of short-termHRV −SD1 and standard deviation of long-term HRV −SD2). The SDNN, LF, and SD2 remaineddecreased during the recovery time. The CG showed significantly reduced: RR, rMSSD, numberof pairs of adjacent NN intervals differing by more than 50 ms (pNN50), LF, HF, SD1, andsample entropy (SampEn). Among these parameters, only RR remained decreased duringrecovery time. Comparisons of the means of HRV parameters evaluated between the CG andSCIG showed that the SCIG had significantly lower pNN50, LF, HF, and SampEn beforetraining, while immediately after training, the SCIG had significantly lower SDNN, LF, HF,and SD2. The rMSSD30s of the SCIG significantly reduced in the windows 180 and 330 secondsand between the windows 300 seconds in the CG. [Conclusion] There was a reduction ofsympathetic and parasympathetic activity in the recovery period after the training in bothgroups; however, the CG showed a higher HRV. The parasympathetic activity also graduallyincreased after training, and in the SCIG, this activity remained reduced even at threeminutes after the end of training, which suggests a deficiency in parasympatheticreactivation in quadriplegics after SCI.